A 46-year-old male presented for evaluation of lesions on the superior gluteal cleft that he could palpate but were asymptomatic. He was otherwise healthy and there was no exposure history or history of trauma.
A biopsy revealed the rare variant of porokeratosis ptychotropica. As of 2014, there were less than 25 reports in the literature. A biopsy will confirm the diagnosis. Multiple lesions can be removed by liquid nitrogen or via a shave biopsy as they typically do not respond to topical medications.
Reference:
D’souza P, Dhali TK, Arora S, et al. Porokeratosis ptychotropica: a rare variant of porokeratosis. Dermatol Online J. 2014;20(6)